Are our kids targets of Depression Incorporated?

October 13 2002
The Sun-Herald

Five-year-olds are being diagnosed
with depression and over-protective parents are partly to blame. But are they also the victims of an industry? Frank Walker reports.

Look at this list of symptoms: irritability or anger, persistent feelings of sadness and hopelessness, increased sensitivity to rejection, eating or sleeping too much or too little, vocal outbursts or bouts of crying, difficulty concentrating, unexplained fatigue and low energy, persistent stomach aches and headaches, withdrawal from social, school and family activities, feeling worthless and guilty and having thoughts of death or suicide.

If you recognise many, it is not surprising. These are the signs parents are supposed to watch for, in case their children are suffering from depression.

Most of us would score several in a week, some would flip through a couple in a day. And kids - well, they'd go through the lot in a few minutes.

You'll find this list of symptoms on the internet, with a link to the "depression bookstore" offering dozens of books, "most written by experienced professionals".

The severity and importance of depression must not be trivialised. Itisa much underestimated and serious illness. Most of us know somebody who has suffered from it.

But headlines last week declaring "Children at age five are 'depressed"', with research showing that 15 per cent of children, some as young as five, have been diagnosed with depression, clearly can send parents into panic.

A Medical Journal Of Australia report says more children than ever are suffering from depression. Its author, Professor Ian Hickie, said part of the problem was that parents were passing their anxieties on to their children.

"Ironically, parents trying to protect their children from harm are actually doing harm," Hickie said. "We have made kids fearful of the world. By trying to protect the children we have deprived them of much-needed outside experiences and interaction with adults outside the family."

The figures are horrifying: more than 800,000 adults and 95,000 children and teenagers are affected by depression a year. It will be second only to cardiovascular disease within 20 years as the main cause of disability and premature death.

When asked if the term "depression" was being overused to describe children who were moody, sad, or just normal kids, Hickie said the problem was even greater than the figures suggested. "All the evidence is the opposite," he said. "We ignore a great deal of emotional disturbance. To say the behaviour of some disturbed kids is normal, that they will grow out of it, ignores the problem - and not providing support is much more dangerous."

He said about 5pc of primary school age children suffered from depression and another 10pc could be classified as suffering anxiety.

Yet in 2000 the Health Department put a questionnaire before 4,500 children and adolescents. They and their parents were asked to tick boxes relating to behaviour and feelings: the higher the score, the closer to being categorised as having depression or other mental health problems.

While 15pc of children aged from 4 to 12 scored as having mental health problems, just 3.5pc were anxious or depressed. The largest problems identified were delinquent behaviour (7.1pc), attention problems (6.1pc) and aggressive behaviour (5.2pc).

Hickie, a respected expert in depression, is also chief executive of beyondblue, a Melbourne group headed by former premier Jeff Kennett set up with taxpayers' money to destigmatise depression and alert Australia to how widespread the condition is. They are working on research that says one in five teenagers experiences depression.

But could the fears and anxieties these declarations cause be overstating the problem?

Certainly some fear there is a booming Depression Inc growing rich by offering instant solutions to age-old problems of difficult children. The pharmaceutical industry is thriving as more and more pills are prescribed for what is seen as aberrant behaviour.

Ten years ago depression was the 10th most diagnosed condition by GPs; now it is the fourth highest. The use of antidepressants has doubled in the past decade and in the US 10pc of the population take them.

Sydney's Bereavement Care Centre co-director Mal McKissock said doctors were too ready to slap the label on children who were understandably sad after losing a parent.

"As soon as we start treating normal emotion as depression, we are in trouble," McKissock said. He is sceptical of research claiming depression is so widespread.

"I think there is a conflict of interest when drug companies are sponsoring the research and governments are responding to it," he said.

Others argue that basic emotions are being drugged out of people. DrJon Jureidini, head of psychological medicine at Adelaide's Women's and Children's Hospital, calls it "the medicalisation of unhappiness".

Child psychiatrist Dr Louise Newman said increased recognition and destigmatisation of depression among adults was a double-edged sword for children. "When young children are very disruptive and won't settle, we have a culture where many people think, 'What's the cure?'," she said. "Parents, like anyone, often want a quick cure."